Having twice worked in hospitals, I can say with certainty that while life as a physician, nurse, tech or other caregiver in a medical unit is very strictly circumscribed by routine, it is also, conversely, unpredictable. Staff know what they’ll be doing each day, but have no idea what will transpire. Minute by minute, a patient’s treatment and recovery – and life itself – is held in suspense. It is that very unpredictability, as well as the brutal realities of illness and healthcare delivery, that make hospitals inherently dramatic places to work. It is for those reasons audiences make ratings winners out of primetime television dramas like E.R. and Gray’s Anatomy.

In the spirit of those popular television series, Director/writer Philip M. Magcalas takes an intimate look at one day in the cardiac care unit of a Boston hospital in his independent short feature, Skin and Bone. In that one day, seven people come together and interact as they go about their daily routine performing catheterization procedures, drawing labs, and attending to recovering patients. It’s a day like any other – and yet, unlike any other.

Providing critical care to heart patients is stressful enough without having to do so under the critical eye of Dr. Bradley Marshall Lindemann (John Depew), the pompous attending physician of the hospital's cardiac care unit. Physician Mike (director Magcalas), nurse manager Audrey (Tsana Dimanin), and the other staff are subjected to his scorn, quick temper, and brutal tongue as he races from patient to patient, procedure to procedure. As far as they are concerned, the verbal pummeling they receive at the hands of Marshall is business as usual. But for new techs Michelle (Cassandra Meyer) and Tom (Allen McRae) beginning their first day on the job, their first encounter with the overbearing doctor is like getting hit by a bucketful of ice-cold water. Like the old timers, they don’t escape unscathed.

Into this day arrives physician/researcher Anthony (Shaun Butler) who has traveled from Argentina to shadow Marshall, only to be callously dumped by Marshall onto Mike who becomes responsible for showing the researcher around the unit. And frantic visitors Barry and Marcus (Ryan Petti and Hector Defaz, respectively) race to the bedside of their mother, patient Ileana (Lucy Y. Robinson), who’s just had a heart attack.

Director Magcalas depicts events as they unfold throughout the day, capturing the interactions among staff and between staff and patients. For some patients, there are positive outcomes. For others, sadness and heartbreak. For the staff -- particularly newbies Michelle and Tom -- it’s a day when their clinical skills and stamina will be tested over and over again as they battle on the frontlines of patient care. And for Marshall, it turns out to be a day when he will experience the ultimate irony any physician can face while on the job.

Magcalas does inject some levity to counterbalance the serious tone of his film. He knows that business-as-usual in a hospital setting isn't entirely sombre or humorless. In fact, in workplaces where death in an inevitable variable in the daily pattern, staff are likely to develop an appreciation for gallows humor. And the employees at this critical care unit are no different, as viewers can see in the funny lunch room scene during which veteran staffers regale one another with their respective patient stories, all gleefully told in rather graphic terms.

Unlike its prime time television counterparts, Skin and Bone offers a more truthful and genuine experience of life for healthcare workers in an critical inpatient unit. Magcalas directs with a sure, straightforward approach, avoiding the melodramatic. Rather than using it to manipulate the emotions of the viewer, he keeps his camera at an almost impersonal distance, tending toward medium and long shots, allowing the scenes to speak for themselves. Without exception, the entire cast delivers well acted yet underplayed performances, minus all the dramatic gestures and posturing. It is this approach to the material that lends credence to the proceedings and a genuine "you are there" intimacy. Kudos to Magcalas and his talented cast for a fine piece of cinema.*-JR